RN Case Manager

Location: Vancouver, WA
Date Posted: 04-27-2018
Case Management RN
Vancouver, WA
Case Manager Job Summary: 
  • The Case Manager plays an integral part in the coordination of care assessing the member’s condition and providing them the necessary resources, options, and coordination for a healthy care outcome.
  • The primary responsibility of the Nurse Case Manager is to coordinate and monitor the care of Health Plan members and develop a nursing plan of care.
  • They will participate in interdisciplinary conferences to review clinical assessments, update care plans and determine follow-up frequency.
  • The Case Manager also acts as an advocate for members and their families linking them to other members of the care team to help them gain knowledge of their disease process and to identify community resources for continued growth toward a maximum level of independence. 
Case Manager Background:  
  • Valid, unrestricted state Registered Nurse (R.N.) license.
  • Bachelor’s degree in Nursing preferred. 
  • Certification in Case Management (CCM) is preferred.
  • 2+ years of clinical nursing experience in a clinical, acute care, or community setting. 
  • Around 2-3 years’ experience in a Managed Care Organization (Health Plan/HMO/MSO/TPA/IPA/etc).
  • At least 2-3 years’ experience with utilization review, case management, or care coordination; telephonic case management experience required.
  • Experience working with Federal and State assistance programs (Medicare/Medicaid/etc).
  • Knowledge of healthcare and managed care preferred. 
  • Strong (2+ years) pediatric or complex case management experience preferred.
  • Basic computer literacy (MS Office) and typing skills are necessary.
  • Prefer prior experience with, CCMS, InterQual or other healthcare databases.
  • Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts.
  • Bilingual in English and Spanish (or other languages beneficial to local population) is a plus.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
480.264.0620 (CALL – TEXT – FAX)
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